Bright bunches of flowers, unfurling petals, the rustle of leaves, raindrops on the window pane, dew-speckled grass, the early morning sun
Category: Mental Illness
CBT, OCD and Coming Clean
It’s been a good few weeks since I started CBT, and thought now would be the right time to share my experiences with you so far.
Since my mental health conditions are ongoing, I’ve had multiple assessments and this isn’t the first time I’ve had ‘talking therapy’ in order to help alleviate the symptoms of my anxiety and depression. When I initially presented with mental health problems, we decided counselling would be the best thing. Counselling is more about talking through the issues that are bothering you; CBT is working out how to change your behaviours and learning how to better rationalise your thoughts by searching for ‘evidence’, rather than clinging onto assumptions. Though I actually really benefited from counselling, it was the right thing for the time. I hadn’t explained my deepest, darkest fears before; I hadn’t confided in someone and told them all about my secrets and how I felt about myself and so on. And for that time, counselling was great. It gave me a voice, and provided that undivided attention I needed to address these issues and tackle my mental health head-on. Now I’m at a different stage in my life, and I didn’t feel talking about everything again would be beneficial right now.
This is where CBT comes in. The NHS defines CBT – or cognitive behavioural therapy – as ‘a talking therapy that can help you manage your problems by changing the way you think and behave’, and is particularly useful for ‘anxiety and depression, but can be useful for other mental and physical health problems,’ (NHS, 2014). Rather than just discussing your thoughts, emotions and resulting behaviours, you are actively developing coping strategies and methods to manage your behaviours, which are often unhelpful and perhaps increase feelings of anxiety/depression.
It’s quite a long-winded explanation, so I’ll try and illustrate with an example from my sessions:
Situation : Seeing deadline date in diary
creates
Thoughts and Images: of a bad mark, disappointing others, feeling unworthy and useless
These thoughts and images then produce
Emotions and Physical Sensations: ‘nervous tummy’, palpitations, impending sense of doom and anxiety.
as a result of these emotional and physical sensations, my behaviour changes:
Behaviours/What I did: withdraw, ruminate, ask for reassurance, plan rather than do, hide away from impending situation.
These behaviours then reinforce my Thoughts and images, and so the cycle perpetuates and continues. The idea here is to address the behaviour; it is very difficult to stop the thoughts, but I can stop behaving in an unnecessary and unhelpful way. So, rather than withdraw, perhaps I should focus on what I have done. Changing this focus involves taking into account my good marks, keeping an activity diary to show myself what I have achieved despite how I’m feeling. I know this sounds so simple, but I often get too blinded by my anxiety and depression that I forget what I have done. It helps me immensely to keep track of this.
If you’ve had dealings with anxiety, depression or similar conditions, you’ll know how troublesome assumptions can be. And when I’m at my worst, when the irrational thoughts pop into my mind, it’s so hard to get rid of them. My therapist is keen on getting me to realise that my assumptions – eg ‘people think I’m stupid – are just that; assumed, with no real evidence. Assumptions are largely negative, and don’t help anything, so I’m working on undoing that negative thought process and replacing it with something useful, instead.
Another thing we’ve identified during my sessions is the fact I have OCD -obsessive, compulsive disorder – and have been engaging in classic ‘OCD’ behaviours, including repeatedly checking. This was a bit of a revelation for me. Admittedly, I did wonder whether the checking I’ve been doing was normal, but I didn’t realise it was OCD. I tend to become fixated with checking various things, including checking locks on doors, both in my own place and when using bathrooms on campus, and sometimes this checking can go on for minutes. On a particularly bad day, I’ll go to check multiple times an hour, or wake up and check because I’m so anxious about whatever it is I’m checking. I also like to have certain items arranged in a certain way; the hangers on my clothes rails are often rearranged every night for fear of ‘ruined’ clothes. I am always worried about things breaking because I didn’t put them away properly, so jewellery is often checked and put back, and my alarms set, reset, checked, set, reset, checked…you get the idea. It’s strange. Thing is, I know these things aren’t actually useful, but at the time, checking things is the only way to rid myself of the anxiety. It’s complex, because the more you check, the more you find it difficult to not check. My therapist described these behaviours as coping strategies, as they help me to feel like I’ve regained control, even if it’s just momentarily. And even though I know my door locks as soon as you close it, it just isn’t enough. It’s like my irrational thoughts, and my unhelpful assumptions; I know it isn’t really helpful, but in that moment, and at that time, that’s all I can do to alleviate my worry.
Undoing these things will take time, and will have to be done step-by-step, but for now I’m feeling positive, and I’m hoping to get the most out of my sessions. I have another on Tuesday, and hopefully my progress will continue.
It feels good to be sharing my progress with you. This is a good way for me to see how far I’ve come, and hopefully I’ll be able to look back at these posts and feel proud. I haven’t always been upfront about things, particularly the OCD, and it’s time to just accept it and learn how to deal with it. Mostly I’m sorry that I hadn’t told Drew, or at least not enough. Hopefully I’ve rectified that.
It’s fairly stressful over this way, but as always, I’ll find a way.
Hope you’re doing well and look after yourself.
Heather x
ps: here is the link to the NHS page regarding CBT if it’s of any use:nhs.uk/Conditions/Cognitive-behavioural-therapy/Pages/Introduction.aspx
Happiness is
Guinea pig hiccups, working in the summer sun, passersby saying hello, sunglasses and lipstick, shorts and skirts and linen shirts, making plans, dandelion seeds floating away on the breeze
Happiness is
the sun shining on my face, the bright bluebells in the garden, the sun shining through the trees, the veins on a leaf, distant laughter, delicate daisy petals, cats when they stretch and lounge in the sun, cherry blossom confetti,the sizzle in the pan, the first sip of wine.
CBT and working through
Just thought I’d provide a quick update re: counselling etc. Ages ago (when I first presented with MH problems) I probably mentioned having to have an initial assessment to see what things would be most useful. This time around was no different, and almost the entire session comprised of filling out scales to determine levels of anxiety/depression.
I have a lot of difficulty with these scales as I find it so difficult to assign emotions a numerical figure, but they are aiming to assess the degree to which said mental health problems affect your life. I suppose it’s very difficult to assess anyway, and I know scales are one of the only feasible options, but they’re so difficult to navigate. Scales exist in a similar fashion for pain management, and that’s perhaps why I find them so frustrating. I’m always filling them out, and I don’t always understand what they mean/how useful they are.
After filling out these scales, we had a quick chat about my mental health history. These chats are often the most difficult part of assessments; they take you right back to a time you’d rather forget. I always find it difficult to control myself when I talk about things from the past. I know it’s useful to address, but it never gets easier. It’s hard to admit that at one time I had difficulty leaving my room to use the bathroom, never mind leaving the house at all. Though I can appreciate how far I’ve come, it’s never easy to admit that I’ve really, really struggled in the past.
It’s completely my own complex, and I’m aware of that. It just hurts everytime to even think about it.
By the end of the assessment we’d decided CBT would be the best route. I’ve tried counselling, and at the time I had counselling it was extremely useful because I felt I just needed to talk and uncover all my deepest fears. Now that’s done, I don’t feel like it would be of any use. I need to learn how to control these feelings and physical symptoms, and CBT is the best fit for that.
We briefly talked about cycles of thoughts and resulting behaviours, and CBT will hopefully provide the techniques needed to break the cycles and work through the feelings as and when they occur. Thoughts will probably always pop into my mind, and I will always probably feel anxious about some things, but CBT works towards getting that to a manageable level. Recognising the physiological symptoms of anxiety is the first step, and hopefully I’ll be able to work through something to make things easier on bad days.
My first ‘proper’ CBT session starts next week, and I’ll keep you updated on my progress.
I hope you’re enjoying your day so far. It’s gorgeously bright and sunny over here, and I’m waiting for my coffee to cool before taking the first sip.
Mornings like these bring a smile to my face.
Look after yourself,
Heather x
Mental health, mentors and meds
Hello! I hope you’re doing okay. I thought I’d give you a little mental health update, which will be really useful for me to refer back to.
Things are starting to feel a bit better this end, and I’m hoping I’ll see even more progress. I’m crying a lot less – which is a great start – and I’m not as anxious when things don’t quite go to plan. I’m trying to handle things more calmly and think things through rationally, and this has been almost impossible at times, so things are definitely becoming more manageable.
I thought I’d had a blip, and at my last doctor’s appointment we discussed possibly upping my meds, but I’m getting back on track and powering through. I recently started seeing a mentor at university to keep my on track of work. One of my problems is I have very little faith in my work and abilities, so having someone to check in with every week is extremely helpful. It’s great to talk to someone who is completely impartial and she’s really kind and supportive.
I’m also heading back for another lot of counselling next week. I haven’t had a course of counselling for about nine months now, and I used to find it really useful. To make things more enjoyable I made the day all about me; I’d head into town, get some lunch, and sit in the sunshine whilst I waited for my appointment. I’m looking at these new sessions in the same way: they’re for me, and I’m going to get the most out of them. I’m hoping for good things.
I think I’m struggling with accepting the uncertainty of what’s to come, and that’s perhaps why I’ve been having really anxious days. I really like to know where I’m headed, and where I’m going in life, and at the minute I’m in an odd place where I need to look forward, but concentrate on the present. I suppose I need to learn that things will happen, but they’ll happen at their own pace. I’m in the middle of degree applications, job hunting and exploring all my options, and it’s all a little bit scary. I’m worried about coping with pain/fatigue, but I’m so desperate to prove myself.
I know I’ll work something out, but it’s hard not to worry about these things.
I know this is a really rambling post, but I’ll keep you updated on my counselling. Wish me luck!
Hope you’re having a great evening,
Heather x
O
Ps hello from Smudge; she’s been keeping me company.
Giggles at Kardomah 94*
Hello! Here’s another Kardomah 94 review; I know, I just can’t get enough of the place! If you’ve been reading over the past few weeks you’ll know I was asked by the lovely Hannah if I fancied checking out some live shows at Kardomah 94, which is a restaurant and venue space right in the centre of Hull. The first – Backstage in Biscuit Land – was a magical, eye-opening journey into the world of Jess Thom who lives life with Tourettes syndrome. The second – Giggles: Greater Good Project – is a combination of mental health awareness and a heavy dose of comedy to delight and educate in equal measure.
We arrived at Kardomah 94 hungry and ready to try some of the tasty-sounding pizzas. When we saw Backstage in Biscuit Land we caught a glimpse of the pizzas – huge, stone baked ones, covered crust to crust in an array of toppings – and we couldn’t wait to try one for ourselves.
We started the night the proper way, with a bottle of refreshing Brooklyn Lager. The atmosphere once again didn’t disappoint; each of the tables was studded with softly glowing candles, a delightful array of art hung up on the restaurant walls, and a soft hubbub and clatter of crockery from the open kitchen. What more could you want?
Kardomah 94’s menu has a selection of pizzas with something for everyone, and various snacks and nibbles available for those who are fancying something a little different. Their specials board sported homemade favourites like spicy chilli con carne, and I’m positive even the fussiest of eaters would find something they’d love. I’d been running around doing various errands during the day, and a pizza with a beer seemed like a heavenly combination to me.
I went for the aptly named Sir Albert Gelder pizza; a stone baked, thin base topped with crisp pancetta, blue cheese and a honey drizzle. Drew went for the Hullawaiin (because he’s one of those people that thinks pineapple on a pizza is a good idea…it’s not my cup of tea, but it did look great.) Again, this was generously topped, and wonderfully crisp, and both went down a treat with a beer.
What I really love about Kardomah 94 is its setting; overlooking the historic guild hall on the edge of Hull’s historic Old Town, it is truly a hidden gem. Kardomah 94 hold various events every month – some in association with the University of Hull – and it’s the perfect place to come to eat, drink and learn a thing or two.
It’s bound to be a hit during Hull’s City of Culture Year in 2017!
After our dinner and drinks, it was time for the event itself. Mental health – and mental illness – are very close to my heart. I’ve been dealing with anxiety and depression for a while, and know people close to me who have really suffered in the past. Events like these are essential to spread awareness. I think we’ve come incredibly far from our draconian views on mental health, and though this should be celebrated, we should always strive for more. I’ve been on the receiving end of comments – even from people who know me – which illustrate a complete lack of understanding. I’ve been told to snap out of it; to stop crying. To stop worrying because there’s nothing to worry about. To cheer up; to buck my ideas up. That – though I may not believe it – other people have it worse.
If only it were that easy.
I don’t talk about what triggered my mental health problems on here, but it wasn’t easy, and I don’t think I’ll ever forget it. The amalgamation of certain things in my life – including the traumatic event, living with chronic pain and a brain injury plus everyday stresses – are a difficult and turbulent mix. Telling me the above things is no use. It doesn’t help. If anything you’re just making the situation worse by adding a healthy dose of guilt and self-loathing into the mix.
You are talking to someone who can cry for hours at a time, or – on very bad days – won’t leave the safety of my bed. Telling someone with a mental health problem that they are better off than somebody else completely undermines the difficulties they are having. It is not useful.
It probably is true. But it does not solve the issue. It does not stop.
The Giggles event was founded to raise awareness of mental health. I’m becoming more confident talking about my difficulties, but some people aren’t so keen on sharing. Mental illness still conjures up images of strait jackets and ‘mad-woman-in-the-attic’ imagery, but is many as 1 in 4 people will have a mental health problem in any year. That’s a huge number. And yet – for many – it is still incredibly difficult to talk about. I’ve been met with resistance when I want to talk about my problems. I’ve been warned that people may prejudge me because of my mental health problems, and that I should stay quiet.
I don’t want to. I shouldn’t have to, because my mental health problems are just another facet of my experiences, just like having cerebral palsy, or the fact that I’m a fiend for chocolate and gin. Events like these are exactly what we need, and so many of us need to know that it’s okay to speak up.
The venue space was again rustic and cosy, and as we sat down in our seats we knew we’d be in for a great night.
Gary – the compere and founder of the event – opened the show, and had us all warmed up for one of the more ‘serious’ parts of the show. Fay came on and openly discussed her experiences of living with borderline personality disorder, or BPD. She explained the ‘black and whiteness’ of the disorder; the perpetual conflicting emotions she has over seemingly everyday events. She was eloquent and open, determined and steely with a refreshing outlook on her own experiences. As she noted, many people have heard of depression and anxiety, but it is these mental health problems – the ones that are most misconstrued and misunderstood -that become truly difficult for people to talk about. It was incredibly wonderful of Fay to come and share her story with us, as though these things need to be discussed they aren’t necessarily easy to share. I think I speak on behalf of the audience when I say I was incredibly touched to have a brief insight into her world.
Next up we saw a myriad of comedians, some of which have had their own mental health problems in the past. These comedians spoke frankly about their experiences, but left us laughing. We also participated in a raffle, and all of the proceeds went to Mind, who do a fabulous job providing services to people with mental health problems when they need them.
It is a scary time for people who rely on mental health services to get by. This year will see yet more cuts to mental health services across the country, and as someone who has had to access such services multiple times it’s really worrying to think that these vital services may be taken away. These services are there for me when I’m at my worst, and allow me to discuss my darkest thoughts when I fear no one else will listen.
Although we had a laugh and a giggle at the event, mental health problems are no joke.
At their most devastating, mental health problems can be life-threatening, and I will always support events like this. Now more than ever we must try to find a way to overcome the issues we face; and supporting local services is one step forward. Hull and East Yorkshire Mind strive to do everything they can for people in the local area, and with our help they can continue to implement support and strategies to help those who need it most.
Thanks so much to Kardomah 94 and the Giggles: Greater Good project for having me; I can’t wait to see when you’re next hosting an event.
What do you think of events like these? Would you be interested in attending something similar?
I hope your day is going well!
Heather x
Happiness is…
Snuggling up under the duvet, the smell of coffee in the morning, waking up early and having sun shine through the window, making new friends, getting things done, leisurely walks, helpful nurses at my hospital appointments, squeaking guinea pigs first thing in the morning, cooking, feeling positive
I am confused
I’m unsure whether I’ve had a mental health blip. I don’t know.
I wish I did know.
Yesterday was strange. I had a meeting with a disability officer and I ended up crying in front of her. I suppose the tears were a result of relief and sadness. I explained everything that was bothering me – preparing for the future, dealing with constant pain, worries about not completing my dissertation to a high standard – and I then felt really stupid for letting everything get to me. Hopefully I’m getting help with the pain management as she’s referring me to a course that’ll help me to deal with all the stress that chronic pain brings. I’ll just have to wait for that.
I spent the rest of the day with that familiar anxiety swirling round right in the pit of my stomach, but I persevered. I got on with stuff. I did everything I was supposed to. In the evening went out for a drink and a catch up, and left feeling happy – completely at ease – and everything was lovely. But today I’ve woken up feeling dreadful.
I have already cried. I have a seminar to attend this evening.
Whenever I go for my medication review I always forget these things. I tell my doctor that I’m doing fine – which is mostly true – but often forget to mention these crippling episodes of anxiety. My dreams are so vivid at the minute that I wake up genuinely convinced they were part of my waking life. I’ve never had dreams so lifelike before.
I’m just really confused. I’m dreading today; it’s awful outside and I’ll be coming home in the dark. I’m already wanting to get back into bed but I have reading to do and work to finish.
Even if I did get back into bed I’d feel too anxious to sleep or relax. I’m feeling a strange mixture of confused and ridiculous.
I hope it passes.
Happiness is…
The blossom on the trees, bright sunny days, the jolt of caffeine in my morning coffee, the smell of baking bread, laughing with my mum, the smell of well-loved books, the scrawl of bright blue ink from my pen, the crinkle of a packet.
